Women report feeling pain more intensely than men, says Stanford study of electronic medical records

Women report more-intense pain than men in virtually every disease category, according to Stanford University School of Medicine investigators who mined a huge collection of electronic medical records to establish the broad gender difference to a high level of statistical significance.

Their study, to be published online Jan. 23 in the Journal of Pain, suggests that stronger efforts should be made to recruit women subjects in population and clinical studies in order to find out why this gender difference exists.

The study also shows the value of EMR data mining for research purposes. Using a novel database designed especially for research, the Stanford scientists examined more than 160,000 pain scores reported for more than 72,000 adult patients. From these, they extracted cases where disease-associated pain was first reported, and then stratified these findings by disease and gender.

"None of these data were initially collected for research, but this study shows that we can use it in that capacity," said Atul Butte, MD, PhD, the study's senior author.

The medical literature contains numerous reports indicating that women report more pain than men for one or another particular disease, noted Butte, a professor of systems medicine in pediatrics. "We're certainly not the first to find differences in pain among men and women. But we focused on pain intensity, whereas most previous studies have looked at prevalence: the percentage of men vs. women with a particular clinical problem who are in pain. To the best of our knowledge, this is the first-ever systematic use of data from electronic medical records to examine pain on this large a scale, or across such a broad range of diseases."

The study's first authors were Butte's graduate student Linda Liu and postdoctoral scholar David Ruau, PhD, who splits his time between Butte's group and that of co-author Martin Angst, MD, professor of anesthesia. David Clark, MD, PhD, a professor of anesthesia, was another co-author.

Women Feel More Pain Than Men Women feel more pain and have a harder time coping with pain than men do. Pain management strategies of the future might be more individualized and gender-based.

"Globally, women have more chronic pain than men, more recurrent pain, they are more likely to have multiple sources of pain, and they are definitely neglected as it relates to treatment," said Jennifer Kelly, an independent psychologist in Atlanta.

Kelly presented a review of research on gender and pain today at a meeting of the American Psychological Association.

Along with findings that a combination of genes, hormones, emotions and even social roles influence the experience of pain, accumulating evidence suggests that doctors might some day personalize the management of pain, based on the genders of their patients. For now, scientists are still struggling to understand the nuances of chronic pain, which is notoriously hard to treat.